More Evidence Supports Two Treatments for Women’s Low Desire

Persistent low sexual desire bedevils many women—and their partners. The one drug approved for low desire in women, Addyi (flibanserin), is not particularly effective and has possibly problematic side effects. Meanwhile, a growing body of research shows that two easy-to-implement psychological approaches often help: mindfulness and cognitive behavioral therapy. A recent study adds to the evidence in favor of both.

The Study

German researchers worked with 51 cis-women who complained of low libido. Participants ranged in age from 22 to 69 (average 39). More than three-quarters said they were heterosexual and involved in monogamous relationships. Half were married. Half had children. Their education ranged from vocational training to graduate degrees. Half worked full-time. The rest worked part-time or were students, homemakers, or retired. (The researchers did not specify the women’s race/ethnicity.)

The participants worked their way through an eight-week online program that included text, illustrations, audio recordings, and videos. Half the material provided sex education, while the other half introduced them to either mindfulness-based therapy (MBT, 24 women) or cognitive behavioral therapy (CBT, 27 women). Mindfulness involves a meditative focus on the present moment. Cognitive behavioral therapy corrects misconceptions; for example, I can’t get aroused.

In addition, the program included sex therapy exercises, including self-examination to improve body image, self-sexing with and without vibrators, and sensual touch with their partners. Finally, all the women received personal email coaching from women being trained as clinical psychologists who had also been trained in both MBT and CBT.

With only 51 participants, this study is on the small side, but it had a reasonably wide range of participants. In addition, many sex studies have between 30 and 100 participants, so this one is reasonably in line with similar research. Overall, it appears credible.

The large majority of the women (86 percent) said they found the program effective. Helpfulness differed somewhat by therapy—in the MBT group, 91 percent found it helpful, and in the CBT group, 81 percent.

But both groups showed what the researchers called “a high level of helpfulness.”

Mindfulness Helps Women Overcome Low Desire

Mindfulness helps eliminate emotional “noise” that may derail women’s erotic interests. Instead of obsessing about other responsibilities (school, work, the next load of laundry), mindfulness teaches practitioners to focus on how they feel and experience their lives from moment to moment. Lovemaking also involves detaching from daily responsibilities and focusing on the moment.

Many previous studies have shown that mindfulness helps women rediscover their libidos:

• A research team at the University of British Columbia recruited 117 low-desire women. Forty-nine were placed on a waitlist. Sixty-eight participated in three 90-minute classes over six weeks that explored the causes of low libido, with counseling to minimize causes and instruction in mindfulness meditation. Between classes, the women practiced mindfulness daily at home. After six months, the treatment group reported significantly greater desire, arousal, and lubrication, easier orgasms, and greater satisfaction.
• Investigators at Willamette University in Oregon analyzed eleven studies of mindfulness involving 449 women who complained of low libido, arousal, and orgasm difficulties. “All aspects of sexual function and well-being—exhibited significant improvement.”

Cognitive Behavioral Also Helps Low Desire

In Hamlet, Shakespeare writes: “There is nothing either good or bad, but thinking makes it so.” CBT corrects mistaken thinking that may interfere with sexual interest.

A robust literature shows that CBT helps resolve low desire. Two examples:

• Canadian researchers provided 16 sessions of online CBT to 19 couples, with an average age of 43, whose women complained of low desire. After treatment, the women reported substantially less sexual distress and “large improvements” in desire. Surveyed six months later, the couples reported continued benefits from CBT.
• Researchers in Texas and Canada provided eight group sessions of CBT to 26 women aged 25 to 63 who complained of low desire. The treatment program combined classes with at-home exercises. After treatment, the women reported reduced sexual distress and “significant improvements” in sexual desire and function, regardless of the duration of the women’s relationships or their low desire.

If you’re in a couple with a woman troubled by low libido, you might consider using internet resources to learn more about mindfulness and cognitive behavioral therapy and how they can improve women’s sexual desire. If self-help doesn’t provide sufficient benefit, then I suggest working with a sex therapist familiar with MBT and CBT.

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